Otolaryngologia polska. The Polish otolaryngology
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Osteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses, occurring mainly in frontal and ethmoid sinuses. Surgical removal is done if they extend beyond the boundaries of the sinus, keep enlarging, are localised in the region adjacent to the nasofrontal duct, or if signs of chronic sinusitis are present and, irrespective of their size, in symptomatic tumours. Progressive headaches and chronic inflammation of the adjacent mucous membrane are most common symptoms. ⋯ Conclusions. Resection of small and medium size osteomas of the paranasal sinuses can be safely and radically performed using endoscopic techniques. It allows their radical resection and very good cosmetic effects.
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The 5 cases of salivary duct carcinoma (SDC); very rare, but distinct group of highly malignant salivary gland tumor are presented, and difficulties with pathological and clinical diagnosis is discussed. The SDC developed in single cases in parotid salivary gland, submandibular salivary and in mucosa of maxillary sinus, pyriform fossa and oral cavity (check). In 3 cases the second malignant tumor was present--synchronously (SDC + pleomorphic adenoma in parotid gland; SDC + squamous cell carcinoma in hypopharynx) or metachroneously (squamous cell carcinoma of upper lip followed by SDC). ⋯ The one patient died 13 months after diagnosis and palliative treatment. The three patients are alive with distant metastases to the lung and bones (77, 38 and 18 months after primary treatment was completed). Only one patient with 10 months observation after treatment is living without symptoms of recurrence or metastases.
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Salivary gland neoplasms represent the diverse group of tumours encountered by the head and neck surgeons. ⋯ The frequency of incidence of benign neoplasm was 80%. The most frequent tumour was pleomorphic adenoma--75% and adenolymphoma--16%. Malignant tumours constituted 20% of all gland tumours. Mucoepidermoid (27%) and adenoid cyst (22%) carcinomas were the most common malignant tumour. Tumour stages T3-T4 was in 90%.
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Pleomorphic adenoma (PA) is the most common neoplasm of the major salivary glands. There are three subtypes of malignant PA: carcinoma ex pleomorphic adenoma (CXPA); carcinosarcoma (true malignant mixed tumor) and metastasizing pleomorphic adenoma. The most common subtype of malignant PA is CXPA which develops in primary or recurrent PA. For proper diagnosis of CXPA, a statement of coexistence of pleomorphic adenoma and carcinoma (or carcinoma after prior PA surgery) is needed. Own material is presented because of rarity and clinicopathologic specificity of this neoplasm. ⋯ Malignant transformation of PA occurs in 5 to 25% untreated patients, usually after 15-20 years and warning symptoms are present in the most cases. Fine needle aspiration biopsy has insufficient sensibility and accuracy in detection of malignant character of PA. Clinical picture and histopathological examination determinate the diagnosis of CXPA. Proper histological classification of malignant component can be found difficult. Surgical treatment (alone or with postoperative irradiation), if possible, allows to achieve good locoregional control of CXPA. 5-years survival varied between 30 to 76%. The best method of prevention and treatment of CXPA is early and radical removal of all major salivary glands tumors.
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The aim of the paper is to present the minimally invasive endoscopic video-assisted surgery for the neck on the basis of current literature. The different techniques include pure endoscopic procedures, open video-assisted approach and mini-access. ⋯ The endoscopic surgery offered a valuable approach for chosen lesions of the neck (solitary parathyroid adenoma, thyroid nodules less then 35 mm, submandibular gland sialolithiasis or tumors). The advantages include lower pain intensity within first hours following surgery, lower analgesia request rate, shorter scar length, higher early cosmetic satisfaction.